A man who presented with a locally advanced squamous cell carcinoma.
He underwent a successful resection and adjacent tissue flaps.
•Supported the first medical journal in Duhok, Duhok
•Engaged surgeons in the global surgical community by assisting them with obtaining membership
to professional organization such as the ACS and
•Established an annual Joint Operation Hope, AHPBA,
and World Surgical Foundation Surgical Symposium
to update the medical community on innovations
•Established a trauma team—composed of trauma surgeons, critical care clinicians, a neurosurgeon, and
an emergency medicine clinician—who taught the
local surgeons prehospital patient care, mass casualty
triage, and management of patients exposed to chemical weapons.
At present, efforts are under way to establish telemedicine and tele-fellowship programs. The purpose of
this endeavor is to train clinicians to use telemedicine
as a means to remotely evaluate patients. A memorandum of understanding was signed between the Duhok
University president, the director of the health system
of Duhok, and the surgical team.
Lessons learned through the decades
In the course of our efforts in Kurdistan, we have
learned several lessons that may be of value to other
health care professionals interested in providing
surgical care to patients in underdeveloped countries,
including the following:
•Plan far in advance (at least nine months to a year).
• Start with a fact-finding mission to assess patient needs
to determine the specialties that are in greatest demand.
•Have a reliable contact person at the host institution.
• Travel with the support of a recognized health care outreach organization, such as the ACS Operation Giving
Back Program, AHPBA, Operation Hope, or World Surgical Operation.
•Do your homework, and contact the state department
and the embassy. Make sure to inform the U.S. embassy
once you arrive at your destination.
• Obtain adequate vaccinations and go to the state department Web page to learn more about the host country.
• Obtain medical/airlift insurance in case of an emergency
•Learn as much as possible about the culture and customs of the country where you will be providing care.
The last thing you want to do is to offend the patients
whom you are trying to help.
• Ship supplies ahead of your scheduled arrival, and make
sure a contact person in the host country can verify that
necessary equipment clears customs and is available for
OCT 2016 BULLETIN American College of Surgeons
OUTREACH IN KURDISTAN, IRAQ